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These programmes use non-health-specific content to attract
and engage their audience, while also providing links to
health and wellness resources. The intent is to appeal to the
social, economic and entertainment interests of drug users
as a means to extend beyond those with active interest in
health information, and to deliver health promoting resources
as a complement to otherwise engaging media.
StreetRx.com is an example of this strategy – a website
that gathers and presents information on the street prices
of pharmaceutical drugs. After a strong debut in the United
States, a group of epidemiologists, harm reductionists and
informatics specialists have created an updated version of
the website that asks UK visitors a simple question: did
you get a good deal?
Visitors can view, post and rate prices in a format that
offers price transparency in an otherwise opaque black
market. All submissions are anonymous, localisation is set
to the city level, and the feedback is shared via a simple
price rating scale. This gives users access to information
and assurance of privacy, while preventing the site from
being used to make deals or set up stings.
The site appeals to the interests of people who buy
and sell diverted prescription drugs, while also serving as
a source of information on overdose prevention,
emergency response and addiction recovery. Links to health and wellness
information are subtle but frequently used, with the US version of the site
making more than 10,000 referrals to external resources in the last year.
The appeal of this approach is that it establishes visitors as experts with
valuable information and insights to share, and cultivates a frame of autonomy,
competence and relatedness that the self-determination theory tells us will be
conducive to engagement with health and information-seeking behaviours.
StreetRx also generates insights for harm reduction programmes and
epidemiological research. Using the wisdom of the crowd, the site is able to
identify differences in the appeal of conventional versus abuse-deterrent drug
formulations, regional variances in diverted drug prices and changes in the
localised price and availability of newly released products.
Information on populations’ drug preferences helps harm reductionists to
tailor outreach information to local needs, and assists epidemiologists and
policy makers to understand the effects of pricing, prescribing and access rules
on the diversion of prescription drugs.
In a 2013 paper,
Crowdsourcing black market prices for prescription opioids
,
researchers found that StreetRx data was strongly correlated with conventional
key informant sources and prices on the online Silk Road market.
These insights would not have been possible without the active participation
of tens of thousands of site visitors. They are the result of engaging the curiosity
and expert knowledge of people who use drugs without
relying upon users’ interest in health.
As harm reduction and addiction recovery
professionals strive to reach a larger population of
service users, we should look towards communication
strategies that have appeal beyond health-specific
interests.
By weighing up information-seeking behaviours
focused on pursuit of entertainment, social
engagement or economic interest, we can position
health and wellness information as a natural
complement to drug users’ needs. These strategies are
not alternatives to conventional health promotion and
harm reduction messaging. Rather, they can expand our
audience and create opportunities for wider
engagement in an effort to generate and share
information that serves the public’s health.
Michael Gilbert is a research intern at Epidemico
MEETING PEOPLE WHO USE DRUGS
‘where they’re at’ is a core principle in
the practice of harm reduction. Programmes are carefully designed to be
culturally competent, respectful of dignity, and non-judgmental in their effort to
reduce harms associated with drug use.
One of the challenges facing the harm reduction community is that health
promotion information often comes in the form of media that are health-
specific, and that rely upon their audience’s interest and engagement in health-
seeking behaviours. Billboards and bus stop ads have trouble finding their
target audience, and even the most eye-catching pamphlet or clever infographic
will only reach those who walk into the needle exchange or seek out health-
related information online.
Research on stage-based models of behaviour change suggests that 80 per
cent of people who use drugs are in re-contemplation or contemplation stages,
while 20 per cent are in the preparation stage – and yet our communications
strategies towards people who use drugs are predominantly focused upon
those in the latter group. The discrepancy between the harm reduction
community’s communication strategies and the stage-based distribution of their
audience presents an opportunity to reflect upon how we can ‘meet people
where they’re at’.
An emerging approach to address this challenge is found in programmes that
employ ‘magnet content’ strategies for distribution of harm reduction resources.
Practice exchange|
Information
10 |
drinkanddrugsnews
| September 2014
www.drinkanddrugsnews.com
Michael Gilbert
talks to DDN about
StreetRx.com, a new website that
encourages the exchange of
information between drug users while
also promoting harm reduction
Engagingwith
thE ExpErts